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New meniscal tears after ACL injury: what is the risk? A systematic review protocol
  1. Guri Ranum Ekås1,2,3,
  2. Clare Ardern4,5,
  3. Hege Grindem6,
  4. Lars Engebretsen1,2,3
  1. 1 Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
  2. 2 Oslo Sports Trauma Research Centre (OSTRC), Norwegian School of Sport Sciences, Oslo, Norway
  3. 3 Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  4. 4 Division of Physiotherapy, Linkoping University, Linkoping, Sweden
  5. 5 School of Allied Health, La Trobe University, Melbourne, Australia
  6. 6 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  1. Correspondence to Dr Guri Ranum Ekås, Oslo Sports Trauma Research Centre, Norwegian School of Sports Sciences, Pb 4014, Ullevål stadion, 0806 Oslo, Norway; g.r.ekas{at}


Background Secondary meniscal tears after ACL injuries increase the risk of knee osteoarthritis. The current literature on secondary meniscal injuries after ACL injury is not consistent and may have methodological shortcomings. This protocol describes the methods of a systematic review investigating the rate of secondary meniscal injuries in children and adults after treatment (operative or non-operative) for ACL injury.

Methods We will search electronic databases (Embase, Ovid Medline, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, PEDro and Google Scholar) from database inception. Extracted data will include demographic data, methodology, intervention details and patient outcomes. Risk of bias will be assessed using the Newcastle Ottawa checklist for cohort studies. Article screening, eligibility assessment, risk of bias assessment and data extraction will be performed in duplicate by independent reviewers. A proportion meta-analysis will be performed if studies are homogeneous (I2<75%). If meta-analysis is precluded, data will be synthesised descriptively using best-evidence synthesis. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology.

Ethics and dissemination This protocol is written according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses, and was registered in the International Prospective Register of Systematic Reviews on 22 March 2016.

Trial registration number CRD42016036788.

  • ACL injury
  • ACL reconstruction
  • non-surgical treatment
  • rehabilitation
  • physiotherapy
  • secondary meniscal injury

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  • Contributors GRE is the guarantor and first author of the protocol. LE is her PhD supervisor and has provided advice throughout the process of planning this protocol. GRE, HG and CA drafted the manuscript and outlined eligibility criteria, risk of bias assessment strategy and data extraction criteria. LE reviewed and commented on the manuscript. All authors have contributed to the final design of the protocol. All authors have read this manuscript, provided feedback and taken part in the revision process. All authors have approved the final manuscript.

  • Funding Oslo Sports Trauma Research Center (OSTRC) supports the initiative of this systematic review. GRE is employed by OSTRC during her PhD project. OSTRC can therefore be regarded as the sponsor of this systematic review, but no additional funding has been received for this systematic review. OSTRC is an independent and non-profit research institution focusing on sports trauma and injury prevention research. OSTRC will have no input on the interpretation or publication of the study results.

  • Competing interests LE has received fellowship support and research grants from Arthrex and Smith & Nephew. The authors have no further competing interests to disclose.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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